NPIMap

Organization Active NPI

Onondaga Case Management Services Inc.

  • Adult Mental Health Clinic/Center
  • Syracuse, NY
National Provider Identifier
1497252563
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
8044025A Issued in NY
Legal business name
ONONDAGA CASE MANAGEMENT SERVICES INC.
Practice address
620 Erie Blvd W Ste 208
Syracuse, NY 13204-2457
Phone
(315) 472-7363
NPI assigned
Apr 6, 2018
Organization subpart
Yes
Parent organization
ONONDAGA CASE MANAGEMENT SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott Ebner
Title
Executive Director
Phone
(315) 472-7363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 8044025A NY Primary

Addresses

Primary practice location

620 Erie Blvd W Ste 208
Syracuse, NY 13204-2457

Mailing address

620 Erie Blvd W Ste 208
Syracuse, NY 13204-2457
Phone (315) 472-7363

Other identifiers 1

IdentifierTypeStateIssuer
02717628MedicaidNY

Other names 1

  • Circare Behavioral Health Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111115000319 NY Part B Supplier - Clinic/Group Practice 0547367377 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Syracuse, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Onondaga Case Management Services Inc5 organizations share this tax ID, including this one
Part of
Onondaga Case Management Services Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

620 Erie Blvd W
Syracuse, NY 13204
Phone (315) 472-7363

220 Herald Pl
Ste 3
Syracuse, NY 13202
Phone (315) 472-7363

620 Erie Blvd W
Ste 208
Syracuse, NY 13204
Phone (315) 472-7363

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1497252563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W STE 208",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042457",
            "telephone_number": "315-472-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W STE 208",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042457",
            "telephone_number": "315-472-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONONDAGA CASE MANAGEMENT SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONONDAGA CASE MANAGEMENT SERVICES INC.",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "EBNER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-472-7363"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "8044025A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02717628",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Circare Behavioral Health Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Circare Behavioral Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.